Objective To explore the clinical efficacy and safety of mifepristone combined with misoprostol in the treatment of missed abortion.Methods According to the digital table,184 patients with missed abortion were randomly divided into study group and control group,92 cases in each group.The control group was given oral diethyl-stilbestrol underwent curettage,while the study group was given mifepristone combined with misoprostol therapy under-went curettage.The clinical therapeutic effect and adverse reaction were compared between the two groups.Results The effective rate of the study group after treatment was 95.65%,which was significantly higher than 86.96% of the control group,the difference was statistically significant(χ2 =4.38,P <0.05).Compared with the control group,in the study group,the operative time[(7.22 ±1.11)minute]observed significant relationship,intraoperative hemorrhage volume[(35.68 ±5.62)milliliter]decreased significantly,pregnancy natural rate of discharge(81.52%)was obvi-ously improved,artificial abortion syndrome incidence rate(3.26%)and again the rate of curettage(5.43%)was obviously decreased,and the differences were statistically significant(t =16.10,12.52,χ2 =7.84,8.87,15.93,all P <0.05).The clinical adverse reaction rate in the study group was 16.30%,which was significantly lower than 29.35% in the control group,the difference was statistically significant(χ2 =4.44,P <0.05).Conclusion Mife-pristone combined with misoprostol plays a complementary role,can improve the treatment of missed abortion and has good operation condition.It also can reduce the adverse reactions,complications and pain of patients.It is worth of clinical promotion.

Subcortical ischemic vascular disease (SIVD) is one of the most common subtypes in vascular cognitive impairment.This article reviews the research progress in the aspects of its pathogenesis,neuropsychological performance,imaging changes,and biological markers of SIVD.

A lot of evidence shows that autophagy is involved in the occurrence and development of cerebral ischemia - reperfusion. Autophagy and its related signal transduction pathways may be an effective therapeutic target for ischemic brain injury. This article reviews related signal transduction pathways of autophagy regulation after cerebral ischemia.

By studying the physician-related factors in physicianpatient relationship,authors put forwards that excellent medical skill,good medical ethics,favorable communication ability,and adequate knowledge on relevant legal regulations are four key points to handle the physician-patient relationship harmoniously.This article will supply reference from the above aspects for the all-around quality-based education for medical students.

OBJECTIVE: To explore the factors,general pattern and characteristics of adverse drug reactions(ADR) in children.METHODS: A total of 188 pediatric ADR reports collected in our city from Jan.2002 to Sept.2007 were statistically analyzed in respect of children's age and sex,route of administration,ADR severity,category of drugs involved,organs or systems involved and clinical manifestations etc.RESULTS: Of the 188 pediatric ADR cases,95(50.5%) were induced by intravenous route.A total of 112 kinds of drugs were involved in the ADR,with anti-infective agents showing the highest proportion.Digestive system,neural system,urinary system and skin etc were involved in the ADR.CONCLUSION: Clinic should attach great importance to the monitoring and reporting of pediatric ADR to reduce or avoid the occurrence of ADR.

Objective Observe the fine distribution and morphologic feature of the intramural lymphatics in rats' rectum and to provide the morphological evidence for studying the mechanism of lymphous metastasis of rectum carcinoma.Methods The intramural lymphatics of rectum in rats were studied by light and electron microscopy to obtain some data regarding their fine distribution.Results The intramural capillary lymphatics of rats' rectum were observed in deep lamina propria of tunica membrane and the dermal papilla layer of anal pectin. The intramural capillary lymphatics and lymphatics were both observed in tela submucosa, reticular layer, hypodermis and intermuscular and serosa. The capillary lymphatics in rectums' wall have the similar ultrastructure feature to normal ones. Three kinds of endothelial cells junctions are overlapping-junctions, embedding-junctions and end-to-end-type junctions. About 21% of cell-junctions are opening types. There are normal organelles and many vesicals in the endothelial of capillary lymphatics. Conclusion The distribution of lymphatics in every layer of dentate line upwards are similar to other digestive tubes'. The distribution of lymphatics in anal pecten of rats' rectum are similar to cutis. The results show that big molecule substance and tissue hydrolysate are transporting mainly by opening-junction of endothelial cells and the vesicle system.

Objective To explore the long-term efficacy of botulinum toxin type A injections on facial beauty and its long-term safety.Methods A total of 33 beauty-seekers with botulinum toxin type A treatment for more than five years were reviewed as observation group,using digital muscle palpation meter (Myoton PRO) for the determination of the orbicularis oculi muscle and masseter muscle tension (F),the muscle characteristic parameters,such as muscle hardness (S) using a homemade facial questionnaire test for satisfactory rate of beauty from both beauty-seekers and physicians.At sametime,33 normal adults that never accepted botulinum toxin injection with matched age and gender were collected as control group.The same-sex indicators were dtermined and compared with using statistic analysis t test.Results The pairwised parameters of the same sex and site were comparied between the two groups;average F and S values in the observation group were lower than those of the control group,but no statistically significant difference were observed between the two groups (P＞0.05);in the observation group,average appearance age was 7.3 years younger than the control group,and the facial shape improved significantly.Conclusions Long-term and repeated application of botulinum toxin A is able to remove crow's feet and decrease the masseter and so the injection is safe with high satisfaction to beauty-seekers.

Objective_ To investigate the effect of resting heart rate on the progression to diabetes in impaired glucose regulation patients. Methods A total of 638 patients with impaired glucose regulation, from January 2011 to December 2012 in our endocrinology clinic, were selected for the study. According to the resting heart rate, patients were divided into four groups:<66 beat/min group, 66 to 69 beat/min group, 70 to 75 beat/min group, and>75 beat/min groups. All patients'baseline data were collected. The incidences of diabetes in different resting heart rate groups were compared, and the relationship between resting heart rate and the progression to diabetes was estimated using multiple regression analysis. Results In 704 patients with impaired glucose regulation, 636 patients have been completed 2 years follow-up, or reached the end of follow-up ( diagnosed as diabetes ) , the follow-up rate was 90. 34%. During two years follow-up, the incidence of diabetes of<66 beat/min group, 66 to 69 beat/min group, 70 to 75 beat/min group, and>75 beat/min group were 16. 2%, 19. 4%, 25. 0%, and 33. 0%, respectivlely. And the Cochran Armitage trend test showed that χ2 =11. 109, P=0. 001, the difference was statistically significant ( P<0. 05). According to blood glucose monitoring, the 636 patients with impaired glucose regulation were divided into impaired fasting glucose group, impaired glucose tolerance group and impaired fasting glucose combined with impaired glucose tolerance group:the Cochran Armitage trend test showed that, with the resting heart rate accelerating, the incidence of diabetes increased. The incidence of diabetes in impaired fasting glucose combined with impaired glucose tolerance group was higher than that of impaired fasting glucose group and impaired glucose tolerance group ( P=0. 062, 0. 113). The average resting heart rate in 68 impaired glucose regulation patients progressed to diabetes was (79.8±8.3)beat/min,andin568non-diabetescases,itwas(74.5±7.2)beat/min(t=-5.043,P<0.01). With the use of patients progressing to diabetes as the dependent variable, different resting heart rate group as independent variables, and resting heart rate<66 beat/min group as a reference, the logistic regression analysis showed that the risk of the progression to diabetes increased with the resting heart rate levels. Conclusion Higher resting heart rate is linked to higher risk of diabetes in patients with impaired glucose regulation.

Subcortical ischemic vascular disease (SIVD) is considered to be the most important and common cause of vascular cognitive impairment (VCI). If patients with subcortical ischemic vascular cognitive impairment (SIVCI) and subcortical vascular cognitive impairment (sVCI) can be found early, it is possible that vascular dementia (VaD) can be identified before occurrence and even reverse the process. Recent studies have shown that resting-state functional magnetic resonance imaging (rsfMRI) may provide the objective basis for the diagnosis of SIVCI. This article reviews the application of rsfMRI in the diagnosis of SIVCI.

OBJECTIVE:To investigate the protective effect of the compatibilities of ginsenosides Rg1 and aconitine on myocar-dial cell of in vitro cultured heart failure model. METHODS:The myocardial cells of neonate rat were grouped into normal control group,model group,positive control group(Deslanoside injection,1×10-7 mol/L),ginsenosides Rg1 group(1×10-8 mol/L),acon-itine group (1 × 10-9 mol/L) or their compatibilities groups (1∶1,2∶1,1∶2,V/V). Except for normal control group,other groups were given 0.8%pentobarbital sodium to induce heart failure model of myocardial cells. After modeling,each group was given rele-vant medicine for 1 h,and then the activities of T-ATPase,Ca2+-Mg2+-ATPase,Na+-K+-ATPase in cells were all detected. The activi-ties of acyl carrier protein(ACP)and lactate dehydrogenase(LDH),and the contents of brain natriuretic party(BNP),TNF-α and total glycogen were measured in cell culture fluid. RESULTS:Compared with normal control group, T-ATPase and Ca2+-Mg2+-ATPase activities were decreased significantly in model group;meanwhile,Na+-K+-ATPase activity was increased signifi-cantly,and ACP,LDH activities and BNP content in cell culture fluid were increased significantly(P<0.05). Compared with mod-el group,the activities of T-ATPase in treatment groups were increased significantly,while the activity of LDH in cell culture fluid was decreased significantly;when the volume ratio of ginsenoside Rg1 to aconitine was 2∶1,protective effect was the strongest;the activities of Na+-K+-ATPase in aconitine group and compatibility groups were all decreased significantly,with statistical signifi-cance(P<0.05). The activities of ACP and BNP in cell culture fluid were all decreased in treatment groups,but the content of to-tal glycogen in cells and the TNF-α content of in cell culture fluid had no change (P>0.05). CONCLUSIONS:Compatibility of ginsenosides Rg1 and aconitine can improve ATPase activities and membranous permeability,regulate BNP secretion and protect myocardial cell of heart failure model,especially the compatibility of ginsenosides Rg1 to aconitine of 2∶1 ratio.